§ 27-8-11-11 — Insurer payment to insured for service rendered by noncontracted provider; requirements

Indiana § 27-8-11-11

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 11: Accident and Sickness Insurance─Reimbursement

Text

(a) As used in this section, "noncontracted
provider" means a provider that has not entered into an agreement with
an insurer under section 3 of this chapter.
(b) After September 30, 2009, if an insurer makes a payment to an
insured for a health care service rendered by a noncontracted provider,
the insurer shall include with the payment instrument written notice to
the insured that includes the following:
(1) A statement specifying the claims covered by the payment
instrument.
(2) The name and address of the provider submitting each claim.
(3) The amount paid by the insurer for each claim.
(4) Any amount of a claim that is the insured's responsibility.
(5) A statement in at least 24 point bold type that:
(A) instructs the insured to use the payment to pay the
noncontracted provider if the insured has not paid the
noncontracted provider in full;
(B) specifies that paying the noncontracted provider is the
insured's responsibility; and
(C) states that the failure to make the payment violates the law
and may result in collection proceedings or criminal penalties.

Legislative History

As added by P.L.144-2009, SEC.2.